Ketogenic Diet and Seizures

October 15, 2018

In the Journal Cell this year there was a phenomenal research article regarding the effects of nutritional ketosis on severe seizure disorders. Dr. Christine Olsen and colleagues looked at the root cause of the benefits of a ketogesnic diet for seizure disorders. The reason that I am highlighting this story this week is because of the mechanism behind the healing process. It, yet again, shows how powerful nutrition can be when used correctly in difficult disorders where pharmacological medicine fails.

It has been well known historically that the science of ketosis and ketogenic diets has been a part of neurology for over 2000 years for seizures and was reacquired by modern physicians as a treatment in the 1920's. The ketogenic type of eating is a diet that is made up of roughly 80+% fat and the remaining food is split between carbohydrates and protein.

The high fat diet in the face of extremely low carbohydrates forces the body, through a process called beta oxidation of fats, to make ketones for fuel. These ketones are capable of feeding the brain and almost all the cells in the body. This is likely possible because evolutionarily humans would have had long periods of starvation or high fat meals where only these macronutrients were available providing for survival, a species ultimate driving force for genetic evolution. This is another example of redundant and important systems in human metabolism for survival. For a long time, scientists were unclear as to why this diet was effective for seizure patients. In Dr. Olsen's study, we have a mechanistic connection from the food ingestion to the brain. It revolves around the intestinal microbiome. In her study, animals were fed a ketogenic diet which induced a change in the intestinal bacterial microflora of the mouse leading to a downstream change in the neurotransmitter GABA, gamma Amino-butyric acid. The change in the type and volume of certain bacteria had a direct effect on enzymes and pathways that produce GABA. GABA is a neurotransmitter that down regulates nerve excitation. The GABA levels were shown to be elevated which reduces the brains overall excitation and stops the seizure activity.

They proved that the gut bacteria were necessary for this event to take place by repeating this event in antibiotic treated and germ free mice who did not respond to the ketogenic diet. As soon as they added back the bacteria killed by the antibiotics, the seizure protection was restored.

Going a bit further, they transplanted the gut bacteria from a ketogenic diet mouse to a control diet mouse with seizures and induced the same seizure protection.

Even more interesting is that in a study by Dr.Sutter and colleagues in 2015 there was an increased risk of seizures in select susceptible populations after taking antibiotics.

Taken as a whole, this is not an endorsement of the ketogenic diet for the average American adult and definitely not for children. This is merely a statement that the ketogesnic diet has profound effects on children and adults with severe seizure disorders via changes to bacteria in the microbiome.

For me, some research shows that the ketogenic diet, long term, may change the microbes of the intestine toward an entero-type that is not the healthiest. There is a need for much more research before ketogenic diets should be used by anyone other than seizure patients and brain cancer sufferers.

If you are interested in the emerging research on cancer and ketosis, click the link for Dom D'Agostino below.